The Diagnostic and Prognostic Roles Played by Homocysteine and Other Aminothiols in Patients with Chronic Kidney Disease

Kruglova, Maria Petrovna; Ivanov, Alexander Vladimirovich; Fedoseev, Anatolij Nikolaevich; Virus, Edward Danielevich; Stupin, Victor Aleksandrovich; Parfenov, Vladimir Anatolyevich; Titova, Svetlana Andreevna; Lazareva, Polina Igorevna; Kubatiev, Aslan Amirkhanovich; Silina, Ekaterina Vladimirovna

doi:10.3390/jcm12175653

Cited by 6 publications

(1 citation statement)

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“…In the search for an alternative marker for hypoxia in critically ill patients, in addition to its association with an elevated risk of cardiovascular disease [ 37 , 38 ] and renal disease in diabetic nephropathy [ 39 ] and chronic kidney disease [ 40 ], SAH has also emerged as a metabolite reflecting tissue hypoxia [ 26 , 27 , 28 , 41 ]. Hypoxia causes the breakdown of energy-rich adenine nucleotides, leading to an intracellular accumulation of adenosine [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Mortality Prediction by Kinetic Parameters of Lactate and S-Adenosylhomocysteine in a Cohort of Critically Ill Patients

Schoettler,

Brohm,

Mindt

et al. 2024

IJMS

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Tissue hypoxia is associated with the development of organ dysfunction and death in critically ill patients commonly captured using blood lactate. The kinetic parameters of serial lactate evaluations are superior at predicting mortality compared with single values. S-adenosylhomocysteine (SAH), which is also associated with hypoxia, was recently established as a useful predictor of septic organ dysfunction and death. We evaluated the performance of kinetic SAH parameters for mortality prediction compared with lactate parameters in a cohort of critically ill patients. For lactate and SAH, maxima and means as well as the normalized area scores were calculated for two periods: the first 24 h and the total study period of up to five days following ICU admission. Their performance in predicting in-hospital mortality were compared in 99 patients. All evaluated parameters of lactate and SAH were significantly higher in non-survivors compared with survivors. In univariate analysis, the predictive power for mortality of SAH was higher compared with lactate in all forms of application. Multivariable models containing SAH parameters demonstrated higher predictive values for mortality than models based on lactate parameters. The optimal models for mortality prediction incorporated both lactate and SAH parameters. Compared with lactate, SAH displayed stronger predictive power for mortality in static and dynamic application in critically ill patients.

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